JNS에서 10월호에 출판된 재밌는 논문 입니다.
결론부터 말하자면, 경추체 제거술 후의 수술결과와 합병증(pseudarthrosis)에 흡연여부가 유의하게 영햐을 미친다는 내용 입니다.
흡연여부에 따라 피험자를 비흡연자/ 끊은지 최소 1년이상된 자/ 흡연자 의 3그룹으로 나누었고, 이 피험자들의 30일이내 합병증 발병, 출혈량, 재원일수 등의 항목을 조사하였습니다.
결과적으로 흡연여부는 더 높은 합병증 발병률, 더 긴 재원일수에 영향을 미치는 risk factor로 밝혀졌으며, 감염 및 pseudarthrosis등의 합병증 발병에 특히 영향을 미친다고 합니다.
흡연의 해로움을 객관적 데이터로 보여준 논문입니다.
*Title: The effects of smoking on perioperative outcomes and pseudarthrosis following anterior cervical corpectomy.
경추체 제거술 후의 수술결과와 위관절증에 대한 흡연의 영향
*Authors: Lau D, Chou D, Ziewacz JE, Mummaneni PV
*Bibliography: J Neurosurg Spine. 2014 Oct;21(4):547-58.
Smoking is one of the leading causes of preventable morbidity and death in the US and has been associated with perioperative complications.
-To examined the effects of smoking on perioperative outcomes and pseudarthrosis rates following anterior cervical corpectomy.
▶Subjects: adult patients underwent anterior cervical corpectomy (2006~2011)
2) quitters (quit for at least 1yr)
3) current smokers
▶Statistical analysis: using multivariate analysis
(To define the relationship between smoking and blood loss, 30-day complications, length of hospital stay, and pseudarthrosis)
▶Total 160 patients were included in the study.
(nonsmokers 49.4%, quitters 25.6%, current smokers 25.0%)
▶30-day complication rate: 20.0% (pseudarthrosis: 7.6%)
▶Mean blood loss: 368.3ml
▶Mean length of stay: 6.5days.
-Current smoking status was significantly associated with higher complication rates (p < 0.001) and longer lengths of stay (p < 0.001).
-Current smoking status remained an independent risk factor for both outcomes.
The complications that were experienced in current smokers were mostly infections (76.5%).
(Significantly greater than in nonsmokers and quitters (p = 0.013))
-Current smoking status was also an independent risk factor for pseudarthrosis at 1-year follow-up (p = 0.012).
Smoking is independently associated with higher perioperative complications (especially infectious complications), longer lengths of stay, and higher rates of pseudarthrosis in patients undergoing anterior cervical corpectomy.